Hyperglycemia is when your blood glucose is too high; it is the opposite of hypoglycemia. Hyperglycemia needs to be treated immediately as it is a major cause of complications among people with diabetes.
Hyperglycemia happens when there is no insulin in the blood, not enough insulin in the blood, or the insulin in the blood is not working properly.
The main reason for hyperglycemia for a patient who is being treated for diabetes type 1 is that he/she has not given himself enough insulin. For a type 2 diabetic it could be the same reason, but also his/her insulin is less effective than it should be.
For a patient with diabetes, overeating can bring on hyperglycemia, as can too little exercise on a given day. Mental stress can also bring it on. Remember that your body's supply of insulin is determined by how much you give yourself, and when. For a person who does not have diabetes his/her body will respond automatically with appropriate quantities of insulin.
Symptoms of hyperglycemia
* High blood glucose
* High levels of sugar in the urine
* Very hungry, hungry often (polyphagia)
* Excessive thirst, frequent thirst (polydipsia)
* Excessive and frequent urination (polyuria)
* Blurred vision - Weight loss
* Wounds and cuts heal poorly
* Dry mouth
* Cardiac arrhythmia
* Deep and rapid breathing (kussmaul hyperventilation)
* Impotence (erectile dysfunction)
* Itchy and/or dry skin
* Tiredness
* Stupor
* Coma
Good diabetes management is crucial
Your doctor will tell you what your glucose levels should be and how often you should check it. If you stick to good diabetes management practices your chances of experiencing hyperglycemia are significantly reduced.
Ketoacidosis
As soon as you detect hyperglycemia, treat it immediately. People who experience hyperglycemia and do not treat it run a significantly high risk of going into diabetic coma (ketoacidosis).
Ketoacidosis happens when there is not enough insulin in your blood. Remember that without the insulin your cells cannot get the vital fuel (energy) they need. Your body starts breaking down fats to get its energy. This process of breaking down fats produces ketones - waste products. Large amounts of ketones are bad for you. Excess ketones in your blood will result in frequent urination as your body tries to eliminate it. However, it eventually becomes a losing battle, with the build up of ketones happening faster than their elimination through urination.
Symptoms of ketoacidosis are:
* your breath smells fruity
* nausea and sometimes vomiting
* your mouth is extremely dry
* you are short of breath
Treating hyperglycemia
The American Diabetes Association says exercising can help lower blood glucose levels. If your blood glucose is above 240mg/dl. Check your urine for ketones and do not exercise if there are ketones present as this will raise your blood glucose levels even more!
Reducing your food intake will also help lower your blood glucose. It is important that you stick to your meal plan, which should be worked out with a dietitian or health care professional.
Ask your doctor for the best way to lower blood glucose levels.
If none of the measures mentioned above manages to lower your blood glucose it is possible that your medication may have to be re-scheduled. Your insulin and medication doses may need to be altered, as might their timing (when you have them).
Remember that good diabetes management helps reduce the incidence of hyperglycemia. Learn to detect hyperglycemia quickly so that you can treat it early on.
You cannot take insulin as a pill. If you did, the moment it got to your stomach it would be digested and would never get into your bloodstream.
You have to inject insulin into the fat just under your skin - from there it will get to your bloodstream.
There are many types of insulin. According to the American Diabetes Association (ADA) there are over 20 types of insulin in the American market. They work in different ways, they are made differently, and they vary in price.
Insulin is most commonly made in laboratories today. It can also come from animals, mainly pigs.
Rapid-acting insulin
This type of human insulin starts to work within five minutes of being injected and peaks after about one hour. It continues to be active for 2 to 4 hours. Examples of rapid-acting insulin are lispro marketed by Eli Lilly, insulin aspart marketed by Novo Nordisk, or insulin glulisine marketed by sanofi-aventis.
Short-acting insulin
Also known as Regular (acting) insulin. This type of human insulin reaches your bloodstream approximately 30 minutes after you inject it, and peaks from 2 to 3 hours after injection. It is effective for 3 to 6 hours.
Intermediate-acting insulin
This human insulin takes from 2 to 4 hours to reach the bloodstream after injection. It peaks at 4 to 12 hours. It is effective for approximately 12 to 18 hours.
Long-acting insulin
This insulin gets into your bloodstream about 6 to 10 hours after you inject it. It is effective for 20 to 24 hours. This type of insulin is also known as ultralente.
Pre-mixed insulin
Some patients have to mix two different types of insulin. If they find that difficult they can have the insulin pre-mixed. This is especially useful for people who are visually impaired.
Allergic reaction to insulin additives
The insulin a diabetic takes has additives to keep it free of bacteria and to tweak its time of action. Some patients may have an allergic reaction to some additives found in intermediate and long-acting insulins - however, this is very rare.
Tuesday, December 8, 2009
Treatment for diabetes - how is diabetes managed?
A long time ago
Before insulin was discovered in 1921 Diabetes Type 1 was a fatal disease - most patients would die within a few years of onset. Things have changed a great deal since then.
You can lead a normal life
If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life. Look at our page on Famous Diabetics - there are many of them and they have achieved great things!
Balance insulin intake with food and lifestyle
The quantity of insulin intake must be closely linked to how much food you consume, as well as when you eat. Your daily activities will also have a bearing on when and how much insulin you take.
Checking your blood glucose levels
A person with diabetes has to have his/her blood glucose levels checked periodically. There is a blood test called the A1C which tells you what your average blood glucose levels were over a two-to-three month period.
Type 2 patients need to eat healthily, be physically active, and test their blood glucose. They may also need to take oral medication, and/or insulin to control blood glucose levels.
Prevent developing cardiovascular disease
As the risk of cardiovascular disease is much higher for a diabetic, it is crucial that blood pressure and cholesterol levels are monitored regularly.
Healthy eating, doing exercise, keeping your weight down will all contribute towards good cardiovascular health - some patients will need oral medication for this.
Stop smoking!
As smoking might have a serious effect on the cardiovascular health the patient should stop smoking.
A health care provider
A health care professional (HCP) will help the patient learn how to manage his/her diabetes. The HCP will also monitor the diabetes control. It is important that you know what to do and that a professional is helping and monitoring the management of your diabetes.
In most countries the GP (general practitioner, primary care physician, family doctor) provides this regular care. There are also diabetitians, endocrinologists, cardiologists, nurses, internists, pediatricians, dietitians, podiatrists, ophthalmologists, optometrists, sports specialists and many others.
If a diabetes patient is pregnant she should see an obstetrician who specializes in diabetes (gestational diabetes). There are pediatricians who specialize in caring for the infants of diabetic mothers.
The aim of diabetes management
The main aim of diabetes management is to keep the following under control:
* Blood glucose levels
* Blood pressure
* Cholesterol levels
High and low blood glucose
The patient will need to make sure his/her blood glucose levels do not fluctuate too much.
Hypoglycemia - low blood glucose - can have a bad effect on the patient. Hypoglycemia can cause:
* Shakiness
* Anxiety
* Palpitations, Tachycardia
* Feeling hot, sweating
* Clamminess
* Feeling cold
* Hunger
* Nausea
* Abdominal discomfort
* Headache
* Numbness, pins and needles
* Depression, moodiness
* Apathy, Tiredness, Fatigue, Daydreaming
* Confusion
* Dizziness
* Bad coordination, slurred speech
* Seizures
* Coma
More information on Hypoglycemia is available on our Hypoglycemia page.
Hyperglycemia - when blood glucose is too high - can also have a bad effect on the patient. Hyperglycemia can cause:
* Polyphagia - frequently hungry
* Polydipsia - frequently very thirsty
* Polyuria - frequent urination
* Blurred vision
* Extreme tiredness
* Weight loss
* Cuts and scrapes will heal slowly and badly
* Dry mouth
* Dry or itchy skin
* Erectile dysfunction (impotence)
* Recurrent infections
* Kussmaul hyperventilation: deep and rapid breathing
* Cardiac arrhythmia
* Stupor
* Coma
Before insulin was discovered in 1921 Diabetes Type 1 was a fatal disease - most patients would die within a few years of onset. Things have changed a great deal since then.
You can lead a normal life
If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life. Look at our page on Famous Diabetics - there are many of them and they have achieved great things!
Balance insulin intake with food and lifestyle
The quantity of insulin intake must be closely linked to how much food you consume, as well as when you eat. Your daily activities will also have a bearing on when and how much insulin you take.
Checking your blood glucose levels
A person with diabetes has to have his/her blood glucose levels checked periodically. There is a blood test called the A1C which tells you what your average blood glucose levels were over a two-to-three month period.
Type 2 patients need to eat healthily, be physically active, and test their blood glucose. They may also need to take oral medication, and/or insulin to control blood glucose levels.
Prevent developing cardiovascular disease
As the risk of cardiovascular disease is much higher for a diabetic, it is crucial that blood pressure and cholesterol levels are monitored regularly.
Healthy eating, doing exercise, keeping your weight down will all contribute towards good cardiovascular health - some patients will need oral medication for this.
Stop smoking!
As smoking might have a serious effect on the cardiovascular health the patient should stop smoking.
A health care provider
A health care professional (HCP) will help the patient learn how to manage his/her diabetes. The HCP will also monitor the diabetes control. It is important that you know what to do and that a professional is helping and monitoring the management of your diabetes.
In most countries the GP (general practitioner, primary care physician, family doctor) provides this regular care. There are also diabetitians, endocrinologists, cardiologists, nurses, internists, pediatricians, dietitians, podiatrists, ophthalmologists, optometrists, sports specialists and many others.
If a diabetes patient is pregnant she should see an obstetrician who specializes in diabetes (gestational diabetes). There are pediatricians who specialize in caring for the infants of diabetic mothers.
The aim of diabetes management
The main aim of diabetes management is to keep the following under control:
* Blood glucose levels
* Blood pressure
* Cholesterol levels
High and low blood glucose
The patient will need to make sure his/her blood glucose levels do not fluctuate too much.
Hypoglycemia - low blood glucose - can have a bad effect on the patient. Hypoglycemia can cause:
* Shakiness
* Anxiety
* Palpitations, Tachycardia
* Feeling hot, sweating
* Clamminess
* Feeling cold
* Hunger
* Nausea
* Abdominal discomfort
* Headache
* Numbness, pins and needles
* Depression, moodiness
* Apathy, Tiredness, Fatigue, Daydreaming
* Confusion
* Dizziness
* Bad coordination, slurred speech
* Seizures
* Coma
More information on Hypoglycemia is available on our Hypoglycemia page.
Hyperglycemia - when blood glucose is too high - can also have a bad effect on the patient. Hyperglycemia can cause:
* Polyphagia - frequently hungry
* Polydipsia - frequently very thirsty
* Polyuria - frequent urination
* Blurred vision
* Extreme tiredness
* Weight loss
* Cuts and scrapes will heal slowly and badly
* Dry mouth
* Dry or itchy skin
* Erectile dysfunction (impotence)
* Recurrent infections
* Kussmaul hyperventilation: deep and rapid breathing
* Cardiac arrhythmia
* Stupor
* Coma
Why is it called Diabetes Mellitus?
Diabetes comes from Greek, and it means a siphon. Aretus the Cappadocian, a Greek physician during the second century A.D., named the condition diabainein. He described patients who were passing too much water (polyuria) - like a siphon. The word became "diabetes" from the English adoption of the Medieval Latin diabetes.
In 1675 Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means honey; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. Diabetes mellitus could literally mean "siphoning off sweet water".
In ancient China people observed that ants would be attracted to some people's urine, because it was sweet. The term "Sweet Urine Disease" was coined.
There are three main types of diabetes:
Diabetes Type 1 - You produce no insulin at all.
Diabetes Type 2 - You don't produce enough insulin, or your insulin is not working properly.
Gestational Diabetes - You develop diabetes just during your pregnancy.
(World Health Organization)
Diabetes Types 1 & 2 are chronic medical conditions - this means that they are persistent and perpetual. Gestational Diabetes usually resolves itself after the birth of the child.
Treatment is effective and important
All types of diabetes are treatable, but Type 1 and Type 2 diabetes last a lifetime; there is no known cure. The patient receives regular insulin, which became medically available in 1921. The treatment for a patient with Type 1 is mainly injected insulin, plus some dietary and exercise adherence.
Patients with Type 2 are usually treated with tablets, exercise and a special diet, but sometimes insulin injections are also required.
If diabetes is not adequately controlled the patient has a significantly higher risk of developing complications, such as hypoglycemia, ketoacidosis, and nonketotic hypersosmolar coma. Longer term complications could be cardiovascular disease, retinal damage, chronic kidney failure, nerve damage, poor healing of wounds, gangrene on the feet which may lead to amputation, and erectile dysfunction.
In 1675 Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means honey; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. Diabetes mellitus could literally mean "siphoning off sweet water".
In ancient China people observed that ants would be attracted to some people's urine, because it was sweet. The term "Sweet Urine Disease" was coined.
There are three main types of diabetes:
Diabetes Type 1 - You produce no insulin at all.
Diabetes Type 2 - You don't produce enough insulin, or your insulin is not working properly.
Gestational Diabetes - You develop diabetes just during your pregnancy.
(World Health Organization)
Diabetes Types 1 & 2 are chronic medical conditions - this means that they are persistent and perpetual. Gestational Diabetes usually resolves itself after the birth of the child.
Treatment is effective and important
All types of diabetes are treatable, but Type 1 and Type 2 diabetes last a lifetime; there is no known cure. The patient receives regular insulin, which became medically available in 1921. The treatment for a patient with Type 1 is mainly injected insulin, plus some dietary and exercise adherence.
Patients with Type 2 are usually treated with tablets, exercise and a special diet, but sometimes insulin injections are also required.
If diabetes is not adequately controlled the patient has a significantly higher risk of developing complications, such as hypoglycemia, ketoacidosis, and nonketotic hypersosmolar coma. Longer term complications could be cardiovascular disease, retinal damage, chronic kidney failure, nerve damage, poor healing of wounds, gangrene on the feet which may lead to amputation, and erectile dysfunction.
What is diabetes? What causes diabetes?
Diabetes (diabetes mellitus) is classed as a metabolism disorder. Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood - it is the principal source of fuel for our bodies.
When our food is digested the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present - insulin makes it possible for our cells to take in the glucose.
Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, and lowers the blood sugar level.
A person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose building up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.
When our food is digested the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present - insulin makes it possible for our cells to take in the glucose.
Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, and lowers the blood sugar level.
A person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose building up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.
What Is Migraine? What Causes Migraines?
A migraine is a severe, painful headache that is often preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound. The excruciating pain that migraines bring can last for hours or even days.
Migraine headaches result from a combination of blood vessel enlargement and the release of chemicals from nerve fibers that coil around these blood vessels. During the headache, an artery enlarges that is located on the outside of the skull just under the skin of the temple (temporal artery). This causes a release of chemicals that cause inflammation, pain, and further enlargement of the artery.
A migraine headache causes the sympathetic nervous system to respond with feelings of nausea, diarrhea, and vomiting. This response also delays the emptying of the stomach into the small intestine (affecting food absorption), decreases blood circulation (leading to cold hands and feet), and increases sensitivity to light and sound.
More than 28 million Americans suffer from migraine headaches, and females are much more likely to get them than males.
What causes migraines?
Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches, but many cannot. Potential migraine triggers include:
* Allergies and allergic reactions
* Bright lights, loud noises, and certain odors or perfumes
* Physical or emotional stress
* Changes in sleep patterns or irregular sleep
* Smoking or exposure to smoke
* Skipping meals or fasting
* Alcohol
* Menstrual cycle fluctuations, birth control pills, hormone fluctuations during menopause onset
* Tension headaches
* Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami)
* Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods.
Triggers do not always cause migraines, and avoiding triggers does not always prevent migraines.
What are the symptoms of migraine?
Symptoms of migraine can occur a while before the headache, immediately before the headache, during the headache, and after the headache. Although not all migraines are the same, typical symptoms include:
* Moderate to severe pain, usually confined to one side of the head, but switching in successive migraines
* Pulsing and throbbing head pain
* Increasing pain during physical activity
* Inability to perform regular activities due to pain
* Nausea
* Vomiting
* Increased sensitivity to light and sound
Many people experience migraines with auras just before or during the head pain, but most do not. Auras are perceptual disturbances such as confusing thoughts or experiences and the perception of strange lights, sparkling or flashing lights, lines in the visual field, blind spots, pins and needles in an arm or leg, or unpleasant smells.
Migraine sufferers also may have premonitions called prodrome that can occur several hours or a day or so before the headache. These premonitions may consist of feelings of elation or intense energy, cravings for sweets, thirst, drowsiness, irritability, or depression.
How is migraine diagnosed?
Physicians will look at family medical history and check the patient for the symptoms described above in order to diagnose migraine. The International Headache Society recommends the "5, 4, 3, 2, 1 criteria" to diagnose migraines without aura. This stands for:
* 5 or more attacks
* 4 hours to 3 days in duration
* At least 2 of unilateral location, pulsating quality, moderate to severe pain, aggravation by or avoidance of routine physical activity
* At least 1 additional symptom such as nausea, vomiting, sensitivity to light, sensitivity to sound.
Tests such as electroencephalography (EEG), computed tomography (CT), magnetic resonance imaging (MRI), and spinal tap may also be performed that check for:
* Bleeding within the skull
* Blood clot within the membrane that covers the brain
* Stroke
* Dilated blood vessel in the brain
* Too much or too little cerebrospinal fluid
* Inflammation of the membranes of the brain or spinal cord
* Nasal sinus blockage
* Postictal headache (after stroke or seizure)
* Tumors
How is migraine treated and prevented?
Migraine treatment (abortive therapies) and prevention (prophylactic therapies) focus on avoiding triggers, controlling symptoms, and taking medicines. Over-the-counter medications such as naproxen, ibuprofen, acetaminophen (paracetamol), and other analgesics like Excedrin (aspirin with caffeine) are often the first abortive therapies to eliminate the headache or substantially reduce pain. Anti-emetics may also be employed to control symptoms such as nausea and vomiting.
Serotonin agonists such as sumatriptan may also be prescribed for severe migraines or for migraines that are not responding to the over-the-counter medications. Similarly, some selective serotonin reuptake inhibitors (SSRIs) - antidepressants such as tricyclics - are prescribed to reduce migraine symptoms although they are not approved in all countries for this purpose.
Another class of abortive treatments are called ergots, which are usually effective if administered at the first sign of migraine. Other drugs have also been used to treat migraine such as combinations of barbituates, paracetamol or aspirin, and caffeine (Fioricet or Fiorinal) and combinations of acetaminophen, dichloralphenazone, and isometheptene (Amidrine, Duadrin, and Midrin). If vomiting makes drugs difficult to ingest, anti-emetics will be prescribed.
Migraine prevention begins with avoiding things that trigger the condition. The main goals of prophylactic therapies are to reduce the frequency, painfulness, and duration of migraine headaches and to increase the effectiveness of abortive therapies. There are several categories of preventive migraine medicine, ranging from diet changes and exercise to prescription drugs. Some of these include:
* Prescription beta blockers, anticonvulsants, and antidepressants
* Botulinum toxin A (Botox)
* Herbs and vitamins such as butterbur, cannabis, coenzyme Q10, feverfew, magnesium citrate, riboflavin, B12, melatonin
* Surgery that severs corrugator supercilii muscle and zygomaticotemporal nerve in the brain
* Spinal cord stimulator implantation
* Hyperbaric oxygen therapy
* Vision correction
* Exercise, sleep, sexual activity
* Visualization and self-hypnosis
* Chiropractic care or acupuncture
* Special diets such as gluten free
It is possible for people to get medication overuse headache (MOH), or rebound headache, when taking too many medications in an attempt to prevent migraine.
Migraine headaches result from a combination of blood vessel enlargement and the release of chemicals from nerve fibers that coil around these blood vessels. During the headache, an artery enlarges that is located on the outside of the skull just under the skin of the temple (temporal artery). This causes a release of chemicals that cause inflammation, pain, and further enlargement of the artery.
A migraine headache causes the sympathetic nervous system to respond with feelings of nausea, diarrhea, and vomiting. This response also delays the emptying of the stomach into the small intestine (affecting food absorption), decreases blood circulation (leading to cold hands and feet), and increases sensitivity to light and sound.
More than 28 million Americans suffer from migraine headaches, and females are much more likely to get them than males.
What causes migraines?
Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches, but many cannot. Potential migraine triggers include:
* Allergies and allergic reactions
* Bright lights, loud noises, and certain odors or perfumes
* Physical or emotional stress
* Changes in sleep patterns or irregular sleep
* Smoking or exposure to smoke
* Skipping meals or fasting
* Alcohol
* Menstrual cycle fluctuations, birth control pills, hormone fluctuations during menopause onset
* Tension headaches
* Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami)
* Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods.
Triggers do not always cause migraines, and avoiding triggers does not always prevent migraines.
What are the symptoms of migraine?
Symptoms of migraine can occur a while before the headache, immediately before the headache, during the headache, and after the headache. Although not all migraines are the same, typical symptoms include:
* Moderate to severe pain, usually confined to one side of the head, but switching in successive migraines
* Pulsing and throbbing head pain
* Increasing pain during physical activity
* Inability to perform regular activities due to pain
* Nausea
* Vomiting
* Increased sensitivity to light and sound
Many people experience migraines with auras just before or during the head pain, but most do not. Auras are perceptual disturbances such as confusing thoughts or experiences and the perception of strange lights, sparkling or flashing lights, lines in the visual field, blind spots, pins and needles in an arm or leg, or unpleasant smells.
Migraine sufferers also may have premonitions called prodrome that can occur several hours or a day or so before the headache. These premonitions may consist of feelings of elation or intense energy, cravings for sweets, thirst, drowsiness, irritability, or depression.
How is migraine diagnosed?
Physicians will look at family medical history and check the patient for the symptoms described above in order to diagnose migraine. The International Headache Society recommends the "5, 4, 3, 2, 1 criteria" to diagnose migraines without aura. This stands for:
* 5 or more attacks
* 4 hours to 3 days in duration
* At least 2 of unilateral location, pulsating quality, moderate to severe pain, aggravation by or avoidance of routine physical activity
* At least 1 additional symptom such as nausea, vomiting, sensitivity to light, sensitivity to sound.
Tests such as electroencephalography (EEG), computed tomography (CT), magnetic resonance imaging (MRI), and spinal tap may also be performed that check for:
* Bleeding within the skull
* Blood clot within the membrane that covers the brain
* Stroke
* Dilated blood vessel in the brain
* Too much or too little cerebrospinal fluid
* Inflammation of the membranes of the brain or spinal cord
* Nasal sinus blockage
* Postictal headache (after stroke or seizure)
* Tumors
How is migraine treated and prevented?
Migraine treatment (abortive therapies) and prevention (prophylactic therapies) focus on avoiding triggers, controlling symptoms, and taking medicines. Over-the-counter medications such as naproxen, ibuprofen, acetaminophen (paracetamol), and other analgesics like Excedrin (aspirin with caffeine) are often the first abortive therapies to eliminate the headache or substantially reduce pain. Anti-emetics may also be employed to control symptoms such as nausea and vomiting.
Serotonin agonists such as sumatriptan may also be prescribed for severe migraines or for migraines that are not responding to the over-the-counter medications. Similarly, some selective serotonin reuptake inhibitors (SSRIs) - antidepressants such as tricyclics - are prescribed to reduce migraine symptoms although they are not approved in all countries for this purpose.
Another class of abortive treatments are called ergots, which are usually effective if administered at the first sign of migraine. Other drugs have also been used to treat migraine such as combinations of barbituates, paracetamol or aspirin, and caffeine (Fioricet or Fiorinal) and combinations of acetaminophen, dichloralphenazone, and isometheptene (Amidrine, Duadrin, and Midrin). If vomiting makes drugs difficult to ingest, anti-emetics will be prescribed.
Migraine prevention begins with avoiding things that trigger the condition. The main goals of prophylactic therapies are to reduce the frequency, painfulness, and duration of migraine headaches and to increase the effectiveness of abortive therapies. There are several categories of preventive migraine medicine, ranging from diet changes and exercise to prescription drugs. Some of these include:
* Prescription beta blockers, anticonvulsants, and antidepressants
* Botulinum toxin A (Botox)
* Herbs and vitamins such as butterbur, cannabis, coenzyme Q10, feverfew, magnesium citrate, riboflavin, B12, melatonin
* Surgery that severs corrugator supercilii muscle and zygomaticotemporal nerve in the brain
* Spinal cord stimulator implantation
* Hyperbaric oxygen therapy
* Vision correction
* Exercise, sleep, sexual activity
* Visualization and self-hypnosis
* Chiropractic care or acupuncture
* Special diets such as gluten free
It is possible for people to get medication overuse headache (MOH), or rebound headache, when taking too many medications in an attempt to prevent migraine.
Obesity And Migraine Sufferers More Emotionally Traumatized Than Those With Life-Threatening Conditions
Need another reason to commit to a healthy diet and exercise? Think migraines are just headaches? Migraine and obesity sufferers feel more emotional pain than those dealing with life-threatening conditions like congestive heart failure, prostate cancer, osteoporosis and high blood pressure. In fact, they tend to feel more pessimistic than those diagnosed with depression.
In a study about healthcare influencers, AdSAM®, a non-verbal process of measuring emotional response, and TNS Healthcare found that people who suffer from some severe diseases accept and handle them better than other types of sufferers.
"People suffering from prostate cancer, seem to cope better than those suffering from migraine headaches," said Jon Morris, Ph.D., the president of AdSAM® and a communications professor at the University of Florida.
Results showed that migraine, obesity and erectile dysfunction sufferers essentially feel afraid, disgusted and saddened by their situation. Understanding the emotional impact of these and other conditions is critical to the physician's approach to condition management but also to those loved ones helping a patient through the condition.
Because of their embarrassed state-of-mind, those who suffer from obesity and erectile dysfunction often feel more comfortable talking with influencers - non-healthcare professionals such as relatives, friends, co-workers, etc., rather than physicians.
Obesity sufferers in particular feel most relaxed when discussing healthcare decisions with influencers. For men or women, the research shows that influencers are most often the women in sufferers' lives, such as their spouses, mothers, sisters or female friends.
"Understanding the emotions surrounding the condition and the patients' emotions towards the physician, as well as other influencers, has a major impact on how to communicate effectively with a patient," Morris said.
TNS Healthcare also conducted research into communications in healthcare. The results indicated that an integrated communications program targeted to patients, physicians and influencers is needed to reach and impact people most effectively, especially in today's digital age.
There are countless opportunities to seek healthcare information through the Internet and other channels. Discovering people's true emotions can help physicians identify individual needs and information-seeking preferences.
Source
AdSAM
In a study about healthcare influencers, AdSAM®, a non-verbal process of measuring emotional response, and TNS Healthcare found that people who suffer from some severe diseases accept and handle them better than other types of sufferers.
"People suffering from prostate cancer, seem to cope better than those suffering from migraine headaches," said Jon Morris, Ph.D., the president of AdSAM® and a communications professor at the University of Florida.
Results showed that migraine, obesity and erectile dysfunction sufferers essentially feel afraid, disgusted and saddened by their situation. Understanding the emotional impact of these and other conditions is critical to the physician's approach to condition management but also to those loved ones helping a patient through the condition.
Because of their embarrassed state-of-mind, those who suffer from obesity and erectile dysfunction often feel more comfortable talking with influencers - non-healthcare professionals such as relatives, friends, co-workers, etc., rather than physicians.
Obesity sufferers in particular feel most relaxed when discussing healthcare decisions with influencers. For men or women, the research shows that influencers are most often the women in sufferers' lives, such as their spouses, mothers, sisters or female friends.
"Understanding the emotions surrounding the condition and the patients' emotions towards the physician, as well as other influencers, has a major impact on how to communicate effectively with a patient," Morris said.
TNS Healthcare also conducted research into communications in healthcare. The results indicated that an integrated communications program targeted to patients, physicians and influencers is needed to reach and impact people most effectively, especially in today's digital age.
There are countless opportunities to seek healthcare information through the Internet and other channels. Discovering people's true emotions can help physicians identify individual needs and information-seeking preferences.
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Monday, December 7, 2009
Migraine With Aura Is Associated With Increased Risk Of Stroke
A migraine with aura occurs when temporary visual or sensory disturbances are experienced before or during a migraine headache. A study just published on bmj.com reports that migraine with aura is associated with a twofold increased risk of stroke. Further risk factors for stroke among patients with migraine are being a woman, being young, being a smoker, and using contraceptives containing estrogen.
Up to 20 percent of the population is affected by migraine which is a common chronic disorder. Women are affected up to four times more often than men. Up to one third of sufferers also experience an aura prior to or during a migraine headache. The aura is often described as the perception of a strange light, an unpleasant smell or confusing thoughts or experiences.
For some time doctors have suspected a link between migraine and vascular events such as stroke. In order to further investigate, an international team of researchers analyzed the results of nine studies on the association between any migraine (with and without aura) and cardiovascular disease. To minimize bias, differences in study design and quality were considered.
Findings indicated that migraine with aura is associated with a twofold increased risk of ischemic stroke. This risk is further increased by being female, age less than 45 years, smoking, and estrogen containing contraceptive use.
No associations were found between migraine and heart attack or death due to cardiovascular disease.
In reaction to these findings, the authors suggest that young women who have migraine with aura should be strongly advised to stop smoking. In addition, methods of birth control other than estrogen containing contraceptives should be considered. Also, they suggest the need for further research in order to examine more thoroughly the association between migraine and cardiovascular disease.
In an associated editorial, Elizabeth Loder from Brigham and Women's Hospital, Boston, explains that the absolute risk of stroke for most migraine patients is low. Therefore a doubling of risk is not cause for panic. However, at a population level, this risk deserves awareness because the prevalence of migraine is so elevated.
She suggests that patients who have migraine with aura should be closely monitored and treated aggressively for modifiable cardiovascular risk factors.
"Migraine and cardiovascular disease: systematic review and meta-analysis"
Markus Schürks, instructor, Pamela M Rist, doctoral student, Marcelo E Bigal, director, Julie E Buring, professor, Richard B Lipton, professor, Tobias Kurth, senior researcher
BMJ 2009; 339:b3914
doi:10.1136/bmj.b3914
"Migraine with aura and increased risk of ischaemic stroke"
Elizabeth Loder, chief, division of headache and pain
BMJ 2009; 339:b4380
doi:10.1136/bmj.b4380
bmj.com
Written by Stephanie Brunner (B.A.)
Up to 20 percent of the population is affected by migraine which is a common chronic disorder. Women are affected up to four times more often than men. Up to one third of sufferers also experience an aura prior to or during a migraine headache. The aura is often described as the perception of a strange light, an unpleasant smell or confusing thoughts or experiences.
For some time doctors have suspected a link between migraine and vascular events such as stroke. In order to further investigate, an international team of researchers analyzed the results of nine studies on the association between any migraine (with and without aura) and cardiovascular disease. To minimize bias, differences in study design and quality were considered.
Findings indicated that migraine with aura is associated with a twofold increased risk of ischemic stroke. This risk is further increased by being female, age less than 45 years, smoking, and estrogen containing contraceptive use.
No associations were found between migraine and heart attack or death due to cardiovascular disease.
In reaction to these findings, the authors suggest that young women who have migraine with aura should be strongly advised to stop smoking. In addition, methods of birth control other than estrogen containing contraceptives should be considered. Also, they suggest the need for further research in order to examine more thoroughly the association between migraine and cardiovascular disease.
In an associated editorial, Elizabeth Loder from Brigham and Women's Hospital, Boston, explains that the absolute risk of stroke for most migraine patients is low. Therefore a doubling of risk is not cause for panic. However, at a population level, this risk deserves awareness because the prevalence of migraine is so elevated.
She suggests that patients who have migraine with aura should be closely monitored and treated aggressively for modifiable cardiovascular risk factors.
"Migraine and cardiovascular disease: systematic review and meta-analysis"
Markus Schürks, instructor, Pamela M Rist, doctoral student, Marcelo E Bigal, director, Julie E Buring, professor, Richard B Lipton, professor, Tobias Kurth, senior researcher
BMJ 2009; 339:b3914
doi:10.1136/bmj.b3914
"Migraine with aura and increased risk of ischaemic stroke"
Elizabeth Loder, chief, division of headache and pain
BMJ 2009; 339:b4380
doi:10.1136/bmj.b4380
bmj.com
Written by Stephanie Brunner (B.A.)
Severe Childhood Obesity Linked To Missing DNA
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Researchers in the UK have linked cases of severe childhood obesity to missing DNA that runs in families, whereby members missing the vital genetic chunk are severely obese from a young age, have a strong drive to eat and put on weight very easily; the missing DNA, called SH2B1, is located on chromosome 16 and plays an important role in regulating weight and blood sugar.
The finding has implications for the diagnosis and care of severely obese children, whose condition may be misattributed to abuse, said the researchers.
The study, thought to be the first to show this kind of genetic deletion can cause obesity, is the work of Dr Sadaf Farooqi from the University of Cambridge and Dr Matt Hurles from the Wellcome Trust Sanger Institute, and colleagues, and was published online in the journal Nature on 6 December.
Obesity is on the rise and has become a major public health concern all over the world. Although the increase in the last 30 years is most likely driven by environmental factors such as diet and lifestyle, our genes also play an important part, for instance in determining why some of us are more likely to put on weight than others.
For the study, which was funded by the Wellcome Trust, Farooqi, Hurles and colleagues scanned the entire genomes of 300 severely obese children for mutations in copy number variants (CNVs), large segments of DNA that are either copied or missing in our genes, and which scientists suggest play a vital role in the development of genetic diseases.
They compared them to the genome information of over 7,000 controls, apparently healthy volunteers from the Wellcome Trust Case Control Consortium 2.
The results showed that the children with severe obesity had some CNVs that were different to the controls. The researchers wrote that:
"We identified several rare copy number variants that were recurrent in patients but absent or at much lower prevalence in controls."
Farooqi told the media:
"We found that part of chromosome 16 can be deleted in some families, and that people with this deletion have severe obesity from a young age."
"Our results suggest that one particular gene on chromosome 16 called SH2B1 plays a key role in regulating weight and also in handling blood sugar levels. People with deletions involving this gene had a strong drive to eat and gained weight very easily," he added.
Hurles said:
"This is the first evidence that copy number variants have been linked to a metabolic condition such as obesity. They are already known to cause other disorders such as autism and learning difficulties."
The finding has implications for the diagnosis and social care of severely obese children, whose condition may incorrectly be attributed to abuse by their parents or carers.
For instance, some of the children in the study had been placed on the Social Services "at risk" register because it was assumed that their parents were deliberately overfeeding them: they are now no longer on the register, according to a press statement from the University of Cambridge.
Farooqi said that their findings show that severe obesity is a "serious medical issue that deserves scientific investigation".
"It adds to the growing weight of evidence that a wide range of genetic variants can produce a strong drive to eat," he added, explaining that they hoped this discovery will change "attitudes and practices amongst those with professional responsibility for the health and well-being of children".
"Large, rare chromosomal deletions associated with severe early-onset obesity."
Elena G Bochukova, Ni Huang, Julia Keogh, Elana Henning, Carolin Purmann, Kasia Blaszczyk, Sadia Saeed, Julian Hamilton-Shield, Jill Clayton- Smith, Stephen O'Rahilly, Matthew E Hurles, and I Sadaf Farooqi.
Nature, Published online 6 December 2009.
DOI:10.1038/nature08689
Source: University of Cambridge.
The Claim: High Blood Pressure Will Increase People’s Risk of Losing Their Hair
Scientists are not exactly sure why, but a number of studies have suggested a relationship between blood pressure and men’s baldness, particularly the early-onset kind.
In a study published in 2007, for example, researchers looked at 250 men ages 35 to 65. After controlling for age, high cholesterol, smoking and other variables, they found that hypertension was “strongly associated” with male pattern baldness: those with a blood pressure reading above 120 over 80 had twice the risk of the others.
Other studies have suggested a link between baldness and heart disease. For a 2000 study in The Archives of Internal Medicine, for example, researchers analyzed health records for 22,000 male doctors over 11 years, examining many aspects of their health. Men with mild balding of the crown had a 23 percent higher risk for heart disease, and those whose crowns were completely bald had a 36 percent greater risk.
But the relationship is only a correlation. Researchers suspect hair loss could be among many markers of an increased risk of hypertension, caused in part by higher levels of testosterone and other hormones, and more androgen receptors in the scalp.
THE BOTTOM LINE
Studies suggest that hair loss may indicate an increased risk of high blood pressure and heart disease.
In a study published in 2007, for example, researchers looked at 250 men ages 35 to 65. After controlling for age, high cholesterol, smoking and other variables, they found that hypertension was “strongly associated” with male pattern baldness: those with a blood pressure reading above 120 over 80 had twice the risk of the others.
Other studies have suggested a link between baldness and heart disease. For a 2000 study in The Archives of Internal Medicine, for example, researchers analyzed health records for 22,000 male doctors over 11 years, examining many aspects of their health. Men with mild balding of the crown had a 23 percent higher risk for heart disease, and those whose crowns were completely bald had a 36 percent greater risk.
But the relationship is only a correlation. Researchers suspect hair loss could be among many markers of an increased risk of hypertension, caused in part by higher levels of testosterone and other hormones, and more androgen receptors in the scalp.
THE BOTTOM LINE
Studies suggest that hair loss may indicate an increased risk of high blood pressure and heart disease.
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